Acute Adrenal Insufficiency (Adrenal Crisis)

Overview


Plain-Language Overview

Acute Adrenal Insufficiency (Adrenal Crisis) is a sudden and severe condition affecting the adrenal glands, which are responsible for producing important hormones like cortisol and aldosterone. These hormones help regulate blood pressure, blood sugar, and the body's response to stress. When the adrenal glands fail suddenly, the body cannot maintain these vital functions, leading to symptoms like severe weakness, low blood pressure, and confusion. This condition can be life-threatening if not treated promptly because the body struggles to respond to stress or illness. It often occurs in people with known adrenal problems or after stopping steroid medications abruptly. Recognizing the signs early is crucial for survival.

Clinical Definition

Acute Adrenal Insufficiency (Adrenal Crisis) is a medical emergency characterized by a rapid deficiency of glucocorticoids and often mineralocorticoids due to failure of the adrenal cortex. It commonly results from an acute stressor such as infection, trauma, or surgery in patients with underlying primary adrenal insufficiency (Addison disease) or secondary adrenal insufficiency due to pituitary or hypothalamic dysfunction. The core pathology involves inadequate production of cortisol, leading to impaired vascular tone, hypoglycemia, and electrolyte imbalances like hyponatremia and hyperkalemia. Clinically, it presents with hypotension, shock, abdominal pain, vomiting, and altered mental status. Without rapid recognition and treatment, adrenal crisis can cause multi-organ failure and death. It is a critical complication of chronic adrenal insufficiency or abrupt withdrawal of exogenous corticosteroids.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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